Melissa Waytashek, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1412-39 Issued in WI

Practice address

100 Becker St
Turtle Lake, WI 54889-9205

Phone

(715) 263-4103

NPI assigned

Jul 17, 2014

Last updated

Jul 17, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clear Lake Physical Therapy and Rehab Specialists LLC

  • Physical Therapy Clinic/Center
  • Prairie Farm, WI
  • NPI 1083328785
  NPD (past)
• Clear Lake Physical Therapy and Rehab Specialists LLC

  • Physical Therapist
  • Clear Lake, WI
  • NPI 1083845754
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1881001246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 50TH AVE",
            "city": "CLAYTON",
            "state": "WI",
            "postal_code": "540043508",
            "telephone_number": "320-360-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BECKER ST",
            "city": "TURTLE LAKE",
            "state": "WI",
            "postal_code": "548899205",
            "telephone_number": "715-263-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYTASHEK",
        "first_name": "MELISSA",
        "name_prefix": "Ms.",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "1412-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Lakes Community Health Center, Inc (Northlakes Community Clinic)
• Tessa Traynor, DPT
• Kaleena J Vanderwyst, LPC
• Robert Edward Vogel
• Carla M Vossen, FNP
• Noah Zehringer

• Athletic Trainer in Turtle Lake, WI
• Providers in Turtle Lake, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.